Utilization and Cost Experience of Low-Income Families in Four Prepaid Group-Practice Plans

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Abstract
A number of low-income families through arrangements supported by the Office of Economic Opportunity received medical care through four community-based prepaid group-practice plans. These families required six months to achieve a utilization level not exceeding that of the regular-plan members. As compared to national data, costs were less because of reductions in hospital days for the poor under prepaid group-practice arrangements. The average number of inpatient days per 1000 Office of Economic Opportunity enrollees was 600 days under the group plan; the national average for low-income persons under the age of 65 was about 1000 days. Cost differences between the low-income families and the regular-plan members were minimal when similar benefits were compared. A package of services including comprehensive physician services, prescriptions, mental health and hospital services cost from $137 to $180 per person per year. Support of broader health services may add from $47 to $65 per person per year to the cost. (N Engl J Med 289: 67–72, 1973)

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